Experts say these daily caseloads are unlikely to significantly decline in the coming months, given public fatigue over the virus and a lack of civic or political will for stricter restrictions.
“I wouldn’t expect it to get much better before we have widespread use of a vaccine,” said Eric Toner, a senior scholar with the Johns Hopkins Center for Health Security.
Clifford S. Mitchell, director of the Environmental Health Bureau at the Maryland Department of Health, said that while officials know it’s “theoretically possible” to drive the caseload down further, doing so would carry “a tremendous social cost.”
“We have done, I think, as a state, about as good as you can do getting things really, really low without forcing people to not leave their homes,” said Mitchell, who helps to advise Gov. Larry Hogan (R) on reopening decisions. The state intends to focus on driving down infection rates in hard-hit communities, Mitchell said, and watch how reopenings affect what is essentially the new baseline level of infection.
With more than 7,000 people dead in the pandemic in Maryland, Virginia and the District, health officers are pleading with residents to continue wearing facial coverings and avoiding large gatherings. But experts anticipate that infections will nonetheless increase as governments lift more restrictions and cooling weather sends people indoors. If previous patterns hold, that uptick will prompt a period of heightened anxiety before people let their guard down again, prompting the next ripple of cases.
“We’ll all go through this roller coaster — hopefully with a small amplitude — for the foreseeable future,” Toner said.
Not everyone is ready to buckle under or accept the status quo.
“Plateauing is not a good thing,” D.C. Mayor Muriel E. Bowser (D) said Friday, especially because the city remains unable to connect new cases to older ones to determine how the virus is spreading. “I think it is a good thing that we don’t see new cases in the hundreds, but we still see too many new cases.”
Alexandria City Council member Redella “Del” Pepper (D), who has been in office since 1985 and works often with the city’s senior community, says the current level of infection is not acceptable. “Vulnerable populations, in particular, are going to have to hibernate,” she said, unless people do a better job wearing masks and social distancing. “That’s just the way it is.”
At nursing homes and other long-term-care facilities, staffers continue to struggle to obtain the resources they need to fend off a deadly resurgence of the virus. And while most businesses have returned to some level of operation, the remaining few have no idea of when they’ll be able to reopen.
“It’s of great concern to us that people have just moved on,” said Audrey Schaefer, spokeswoman for the Merriweather Post Pavilion, an outdoor amphitheater in Howard County, Md.
Howard on Friday allowed entertainment venues to reopen with a cap of 100 people. But for Merriweather, which typically hosts events with 6,000 to 18,000 attendees, the order does not bring relief.
Merriweather’s parent company, which also owns the 930 Club, the Anthem and the Lincoln Theatre in the District, has furloughed 95 percent of its 2,500 employees since the start of the pandemic. The company says it is not certain it will be able to survive months more of no revenue without government assistance.
“I’m happy for the other businesses,” Schaefer said, “But here, we are as far from normal as possible. And every day gets worse.”
Restaurants in the region don’t expect the pandemic infection level to improve significantly before the end of the year, said Kathy Hollinger, chief executive of the Restaurant Association of Metropolitan Washington. They’re trying to figure out how to efficiently expand outdoor dining as the weather cools, assuming it will still be unsafe for substantial indoor service.
“It’s been devastating,” she said.
Donta Marshall, vice president for 1199SEIU United Healthcare Workers East, said the Maryland nursing home workers she represents do not think the state should have entered its Phase 3 reopening Friday, given that they still don’t have the masks, gowns and test kits to protect residents — and themselves.
According to state data, 130 nursing homes and assisted-living facilities in Maryland still have active outbreaks, with as many as 7,300 residents and staffers affected.
“It’s easy to say precautions aren’t necessary when you’re not on the front lines,” she said. “When you’ve held the hand of a person dying from the disease . . . absolutely you’ll think we’re moving too quickly.”
As of Friday, nearly 250,000 people in the District, Maryland and Virginia — or about 1 in 62 residents — have tested positive for the novel coronavirus. Virginia is reporting nearly twice as many cases a day than Maryland and has more new cases per capita, a switch from the first few months of the pandemic, when Maryland was hit much harder.
Maryland’s test positivity rate has fluctuated around 4 percent since the start of August, while Virginia’s has hovered between 6 and 7 percent. The rate in D.C. has remained around 3 percent since June.
These rates are lower than in some other parts of the country, such as Florida, Indiana, Nevada and South and North Dakota. But they are higher than in New York, New Jersey and Connecticut, where test positivity has stabilized closer to 1.5 percent.
Part of the reason, said Montgomery County health officer Travis Gayles, is that the greater New York area experienced a more severe peak of the virus in April and May, which justified more draconian restrictions for a longer period. New York’s stay-at-home order, for example, was in effect for 78 days, compared with 44 days in Maryland and Virginia.
“[In New York,] the death toll was high, and covid-19 felt more real for more people,” Gayles said. “Some of challenge we’ve had here is that it’s tricky to get buy-in and consensus for precautions.”
Hogan has in recent weeks urged major Maryland counties to reopen faster, even getting into a drawn-out battle with Gayles last month over in-person instruction at private schools. Hogan announced Tuesday that the state is ready to enter Phase 3 recovery, having “crushed the curve,” but leaders in Montgomery and Prince George’s counties and in the city of Baltimore opted out.
The 60 to 80 new cases Montgomery has been reporting each day is just too high, Gayles said. Though deaths have decreased to one or two a day in the county, from a high of 30 in April, it is still unclear what the long-term side effects of surviving the virus might be.
“From a public health perspective, I refuse to accept that this is the best we can do,” Gayles said.
Mitchell, the Maryland state health official, said foot traffic has been down at several community testing sites, suggesting “testing fatigue” has set in, a concerning sign about a sense of resignation among residents.
More than two-thirds of Virginians surveyed in August thought the virus would not be “contained sufficiently for a return to ‘normal’ ” until next year or longer, according to the Institute for Policy and Opinion Research at Roanoke College.
Similar to the way people experience stages of grief, pandemics have a predictable pattern of psychological processing, experts said: An early sense of heroism and community cohesion gives way to a long sense of disillusionment.
Kaye Hermanson, a psychologist at the University of California at Davis, said that most sustained behavior changes are fueled by rewards — such as seeing your weight drop during a diet. But with the coronavirus, the payoff for behavior such as mask-wearing and social distancing is not a positive reward but the absence of a negative event.
“People are feeling like there’s no end in sight. That makes it easier to give up,” Hermanson said. She recommended that people remind themselves to keep taking precautions and to take it one day at a time.
Neil J. Sehgal, a professor of health policy at the University of Maryland, said officials need to factor the public’s fatigue into decisions about reopening. Governments so far have relied on “everybody doing everything right every time,” Sehgal said, such as by exhorting people to avoid cookouts and parties over Labor Day weekend even though gatherings of under 50 people are allowed in all three jurisdictions.
This strategy becomes less tenable the longer the pandemic lasts, Sehgal warned, adding that officials should be prepared to reimpose restrictions if case numbers surge again.
“I don’t think we’re sentenced to our daily case counts,” Seghal said. “But it’s just highly unlikely that with our current set of plans, that we’re going to see cases decline.”
Michael Brice-Saddler, Emily Davies and Emily Guskin contributed to this report.